Cannabinoid Hyperemesis Syndrome and Panic Disorder in a Pregnant Woman: Diagnostic and Management Considerations

Cannabis Hyperemesis Syndrome (CHS) is characterized by cyclical intractable nausea and vomiting in chronic cannabis users. These symptoms are pathognomonically relieved by hot showers and baths. In spite of the recognized antiemetic properties of cannabis, a paradoxical effect of hyperemesis is described in CHS. The present case is that of a 29-year-old, 15-week pregnant woman who presented with symptoms suggestive of Cannabis induced panic disorder and Cannabis Hyperemesis Syndrome. The patient was stabilized symptomatically with intravenous fluids, antiemetics and later set up on long-term drug rehabilitation. The case highlights the need for clinicians to recognize symptoms of CHS in pregnant women in whom these symptoms may resemble other diagnoses. The incidence of Cannabis Hyperemesis Syndrome is projected to increase with the rise in marijuana use and legislative attempts to decriminalize recreational marijuana.